| NPI | 1447594312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE J POPE Owner 402-669-6204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 992) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NE 871) |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |